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Are there any known long term side affects of having too much Botox?

“I have a question. I am a proud believer of Botox.  In my years I have purchased many pricey eye creams, they do moisturize but don’t do the miracle work of a Botox injection.  I have been receiving Botox for many years now maybe 3 to 4 times a year.  Are there any known long term side affects of having too much Botox.         Monica M. Newport Beach, CA


Botox® and Dysport® are both similar, botulinum type A proteins which interfere with the impulse sent by nerves to the targeted muscles.   In nature, this protein is manufactured by bacteria which causes food poisoning, and causes its detrimental effects by having the bacteria spread throughout the body and continue to manufacture the protein, which will paralyze vital muscles and can cause death.   Botox® the medication is produced in a laboratory (by a local company, Allergan from Irvine) and is the purified protein, without the bacteria, and will only weaken the muscle into which it is injected. It is an incredibly safe medication if used properly, and has been extensively studied.    Its use was first described for blepharospasm, a condition in which one of the eye muscles over reacts – injecting a drop of Botox® calms the muscle down and gives the patient relief of their symptoms for about 3 months. Botox® has also been used to help patient with severe neck or jaw muscle spasms and the stop axillary (i.e. arm pit) sweating in patients with abnormally active sweat glands.   But of course, most of us know Botox® best because of its ability to weaken muscles between our brows, forehead or in the crow’s feet areas, thus makes our wrinkles less noticeable! The goal of our Botox® injections is to minimize your visible wrinkles, not to paralyze your muscles of expression completely! Once injected into a muscle, Botox® weakens that muscles ability to contract (and cause wrinkles) – it does not travel to other body sites or cause weakness beyond the area of injection.    The only complications I have seen from Botox® are temporary muscle weaknesses if the drug was injected beyond the area where the desired effect was to take place. For example, if one injects too close to the outer third of the eyebrow, the eyebrow can sag, giving the patient an appearance of a lazy eye – thus, we do not inject in this area! Likewise, I do not like to inject Botox® into lips in an effort to reduce lip lines because some weakness of the lip will result, for example, making it more difficult to suck through a straw.   Used properly, Botox® can give a patient a very satisfying result with very little risk! Let me show you an example of a patient with a pleasing result from a Botox® injection.

Example 1

46 year old female, maximally frowning before and a month after receiving 30 units of Botox®. Notice that some lines remain, but the desired effect of softening the furrows and making the patient appear less angry has been achieved. Actual patient of Dr. Bunkis of Orange County Plastic Surgery in Newport Beach, CA – your results may vary.

Example 2

Same patient, raising her brows, before and after a Botox® injection. Notice that the lines over her lateral brows have not been corrected to avoid the possibility of causing a brow droop. Actual patient of Dr. Bunkis of Orange County Plastic Surgery in Newport Beach, CA – your results may vary.

If you have any specific questions about cosmetic procedures, your best bet would be to see a qualified plastic surgeon to review your options. Pease feel free to contact our office at 949-888-9700 to set up an appointment with Dr. Bunkis or our Physician Assistant, Crystal Osborn; you may also check out our website at www.orangecountyplasticsurgery.com  to see further examples of similar patients.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.